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1.
Brachytherapy ; 22(3): 389-399, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36922243

RESUMO

PURPOSE: Granulation tissue-induced tracheal stenosis (mainly secondary to intubation or lung transplantation) is one of the most common etiologies of benign airway obstructions. Recurrence rates after standard treatment options (surgical resection and/or endobronchial interventions) can inadvertently worsen the stricture through the stimulation of more granulation tissue generation (via increased fibroblast activity and roliferation). Low-dose radiotherapy could be a promising tool to prevent granulation tissue formation after surgery and/or endobronchial interventions regarding its established role in the treatment of keloids or hypertrophic scars, two benign diseases with similar a pathophysiology to tracheal stenosis. This study reviews case reports and small series that used endobronchial brachytherapy (EBBT) or external beam radiotherapy (EBRT) for the management of refractory granulation tissue-induced tracheal stenosis after surgery and/or endobronchial interventions. METHODS AND MATERIALS: Case reports and series (published up to October 2022) that reported outcomes of patients with recurrent granulation tissue-induced tracheal stenosis (after surgery and/or endobronchial interventions) treated by EBBT or EBRT (in definitive or prophylactic settings) were eligible. RESULTS: Sixteen studies (EBBT: nine studies including 69 patients, EBRT: seven studies including 32 patients) were reviewed. The pooled success rate across all studies was 74% and 97% for EBBT and EBRT, respectively. CONCLUSIONS: Radiation therapy appears to be effective in the management of selected patients with recurrent/refractory tracheal stenosis. Response to this treatment is usually good, but further studies with a larger number of patients and long-term followup are necessary to determine the optimal technique, dose, and timing of radiation therapy, late complications, the durability of response, and criteria for patient selection.


Assuntos
Obstrução das Vias Respiratórias , Braquiterapia , Estenose Traqueal , Humanos , Braquiterapia/métodos , Estenose Traqueal/prevenção & controle , Estenose Traqueal/complicações , Tecido de Granulação/efeitos da radiação , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/radioterapia
2.
Ultrasound Med Biol ; 47(4): 1054-1066, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33454160

RESUMO

Chronic wounds, including diabetic, leg and pressure ulcers, impose a significant health care burden worldwide. Some evidence indicates that ultrasound can enhance soft tissue repair. However, therapeutic responses vary among individuals, thereby limiting clinical translation. Here, effects of pulsed ultrasound on dermal wound healing were assessed using a murine model of chronic, diabetic wounds. An ultrasound exposure system was developed to provide daily ultrasound exposures to full-thickness, excisional wounds in genetically diabetic mice. Wounds were exposed to 1 MHz ultrasound (2 ms pulse, 100 Hz pulse repetition frequency, 0-0.4 MPa) for 2 or 3 wk. Granulation tissue thickness and wound re-epithelialization increased as a function of increasing ultrasound pressure amplitude. At 2 wk after injury, significant increases in granulation tissue thickness and epithelial ingrowth were observed in response to 1 MHz pulsed ultrasound at 0.4 MPa. Wounds exposed to 0.4 MPa ultrasound for 3 wk were characterized by collagen-dense, revascularized granulation tissue with a fully restored, mature epithelium. Of note, only half of wounds exposed to 0.4 MPa ultrasound showed significant granulation tissue deposition after 2 wk of treatment. Thus, the db+/db+ mouse model may help to identify biological variables that influence individual responses to pulsed ultrasound and accelerate clinical translation.


Assuntos
Complicações do Diabetes/terapia , Tecido de Granulação/efeitos da radiação , Reepitelização/efeitos da radiação , Pele/lesões , Terapia por Ultrassom , Ferimentos e Lesões/terapia , Animais , Doença Crônica , Colágeno/metabolismo , Modelos Animais de Doenças , Proteínas Filagrinas , Tecido de Granulação/irrigação sanguínea , Tecido de Granulação/patologia , Proteínas de Filamentos Intermediários/metabolismo , Masculino , Camundongos , Neovascularização Fisiológica , Distribuição Aleatória , Pele/patologia , Ondas Ultrassônicas , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologia
3.
Biomed Pharmacother ; 123: 109776, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31911295

RESUMO

We determined the impact of Photobiomodulation (PBM) and metformin administration alone and combined on the inflammation and proliferation steps of wound healing of incisions in type two diabetes mellitus (T2DM) rats. 40 rats were divided into 4 groups (n = 10 each group). A non-genetic model of T2DM was induced in all rats, and an incision was made on each rat. There were 4 groups as follows: Group 1 was control group. Group 2 received PBM alone (890 nm, 80 Hz, 0.324 J/cm2, daily). Group 3 received metformin alone (50 mg/kg, i.p., daily) and the fourth group received combination of PBM + metformin. At inflammation (day 4) and proliferation (day 7) steps, tensiometerical, stereological, and immunohistochemical examinations were performed. PBM and PBM + metformin treatments significantly increased wound strength at inflammation and proliferation steps of wound healing respectively. PBM, metformin, and PBM + metformin groups significantly decreased inflammatory cells at inflammation and proliferation steps of wound healing. PBM, metformin, and PBM + metformin groups significantly improved granulation tissue formation by increasing fibroblasts, and new blood vessel formation at inflammation and proliferation steps of wound healing. Metformin significantly increased M2 macrophages than other treatment groups at inflammation and proliferation steps of wound healing. Simultaneously, PBM significantly decreased M2 macrophages than control group. We concluded PBM and PBM + metformin treatments significantly hastened repair at the inflammation and proliferation steps of repairing skin injury in a non-genetic model of T2 DM. PBM + metformin showed a synergistic impact. There were not a positive relation between M2 macrophage number and wound strength in the studied groups. The details of the molecular mechanisms of PBM, and PBM + metformin treatments of repairing wounds in animals, and treatment of DFUs of patients with T2 DM should be elucidated by further research.


Assuntos
Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Tipo 2/terapia , Terapia com Luz de Baixa Intensidade , Metformina/farmacologia , Cicatrização , Animais , Glicemia/metabolismo , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/efeitos da radiação , Terapia Combinada , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/patologia , Tecido de Granulação/efeitos dos fármacos , Tecido de Granulação/patologia , Tecido de Granulação/efeitos da radiação , Inflamação/patologia , Macrófagos/efeitos dos fármacos , Macrófagos/efeitos da radiação , Masculino , Ratos Wistar , Cicatrização/efeitos dos fármacos , Cicatrização/efeitos da radiação
4.
Lasers Med Sci ; 34(4): 721-728, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30276489

RESUMO

The aim of this study was to evaluate the effects of blue light-emitting diode (LED) on the healing process of third-degree skin burns in rats through clinical and histological parameters. Forty male Wistar rats were divided into two groups: control (CTR) (n = 20) and blue LED (BLUE) (n = 20), with subgroups (n = 5) for each time of euthanasia (7, 14, 21, and 28 days). LED (470 nm, 1 W, 12.5 J/cm2 per point, 28 s) was applied at four points of the wound (total, 50 J/cm2). Feed intake was measured every other day. It was observed that there were no statistically significant differences in the Wound Retention Index (WRI) of the BLUE group in relation to CTR group (p > 0.05) at the evaluation times. After 14, 21, and 28 days, it was observed that the animals in the BLUE group consumed more feed than animals in the CTR group (p < 0.05). At 7 days, there was a statistically significant increase in the angiogenic index (AI) in BLUE (median: 6.2) when compared to CTR (median: 2.4) (p = 0.01) and all animals in BLUE had already started re-epithelialization. This study suggests that blue LED, at the dosimetry used, positively contributed in important and initial stages of the healing process of third-degree skin burns.


Assuntos
Queimaduras/patologia , Queimaduras/radioterapia , Luz , Fototerapia , Pele/patologia , Pele/efeitos da radiação , Cicatrização/efeitos da radiação , Animais , Comportamento Alimentar , Tecido de Granulação/patologia , Tecido de Granulação/efeitos da radiação , Inflamação/patologia , Masculino , Neovascularização Fisiológica/efeitos da radiação , Ratos Wistar , Reepitelização/efeitos da radiação , Pele/irrigação sanguínea
5.
J Cosmet Laser Ther ; 18(8): 432-437, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27351234

RESUMO

OBJECTIVE: Wound healing can be aided by the use of low- and medium-intensity lasers. The use of pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) high-intensity laser therapy (HILT) with a 1064-nm wavelength laser provides deeper and more efficient penetration into tissue as it is being less absorbed by chromophores in tissue, e.g., hemoglobin, melanin, and water, thereby enhancing the wound-healing process. In this study, we examined the effect of HILT on wound healing with a Q-switched pulsed Nd:YAG laser in an animal model. DESIGN: Sixty SKH1 hairless male mice (seven weeks old) were randomly divided into four groups according to the amount of laser fluence: control, group 1 (0.8 J/cm2), group 2 (1.6 J/cm2), and group 3 (2.0 J/cm2). Laser treatment was provided to groups 1, 2, and 3 with a 1064-nm Q-switched Nd:YAG laser. Histological analysis was performed with hematoxylin and eosin staining, Masson's Trichrome staining, and Ki-67 staining. RESULTS: Statistically significant increases in the accumulation of collagen fibers, thickness of granulation tissue, and numbers of fibroblasts were observed in group 2 (treated with 1.6 J/cm2) as compared with the control (no laser treatment), group 1 (treated with 0.8 J/cm2), and group 3 (treated with 2.0 J/cm2). CONCLUSION: Nd:YAG HILT stimulated fibroblast proliferation and increased extracellular matrix production. We expect that this therapy could accelerate the wound-healing process.


Assuntos
Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Cicatrização/efeitos da radiação , Animais , Colágeno/efeitos da radiação , Fibroblastos/efeitos da radiação , Tecido de Granulação/efeitos da radiação , Masculino , Camundongos , Camundongos Pelados , Modelos Animais , Distribuição Aleatória
6.
Inflammation ; 39(4): 1395-404, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27206919

RESUMO

The aim of the study was to investigate the biochemical and molecular changes in the process of epidermal healing of burn injuries after therapeutic treatment with low-power laser (LPL) and light-emitting diode (LED). Rats were divided into six groups: skin without injury (Sham), burn wounds (BWs), BW + 660-nm LPL, BW + 904-nm LPL, BW + 632-nm LED, and BW + 850-nm LED. The burn wound model was performed using a 100 °C copper plate, with 10 s of contact in the skin. The irradiations started 24 h after the lesion and were performed daily for 7 days. The burn wound groups showed an increase in the superoxide production, dichlorofluorescein, nitrites, and high protein oxidative damage. The activities of glutathione peroxidase and catalase were also increased, and a significant reduction in glutathione levels was observed compared to the control group. However, treatments with 660-nm LPL and 850-nm LED promoted protection against to oxidative stress, and similar results were also observed in the IL-6 and pERK1/2 expression. Taken together, these results suggest that LPL 660 nm and LED 850 nm appear reduced in the inflammatory response and oxidative stress parameters, thus decreasing dermal necrosis and increasing granulation tissue formation, in fact accelerating the repair of burn wounds.


Assuntos
Queimaduras/terapia , Inflamação/terapia , Terapia com Luz de Baixa Intensidade/métodos , Cicatrização/efeitos da radiação , Animais , Queimaduras/patologia , Tecido de Granulação/efeitos da radiação , Lasers Semicondutores , Necrose/prevenção & controle , Estresse Oxidativo/efeitos da radiação , Ratos , Pele/patologia
7.
Lasers Med Sci ; 30(4): 1297-304, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25749659

RESUMO

The aim of this study was to investigate the effects of low-level red laser on tissue repair in rats submitted to second-degree burn, evaluating if the timing of laser treatment influences the healing process. The animals had their backs shaved and divided as follows: control group (n = 12)-rats burned and not irradiated, early laser group (n = 12)-rats burned and irradiated from day 1 after injury for five consecutive days, and late laser group (n = 14)-rats burned and irradiated from day 4 after injury for five consecutive days. Laser irradiation was according to a clinical protocol (20 J/cm(2), 100 mW, continuous wave emission mode, 660 nm) as recommended by the laser device manufacturer. Half of the animals were sacrificed 10 days after burn, and the other animals were sacrificed 21 days after burn. The late laser group accelerated wound contraction 10 and 21 days after burn. The late laser group accelerated reepithelialization 18 days after burn. The late laser group increases the granulation tissue 10 and 21 days after burn. Both irradiated groups increased type III collagen expression and TGF-ß 21 days after burn. Both irradiated groups increased macrophage and myofibroblast numbers 10 days after burn and decreased 21 days after. Low-level red laser exposure contributes to the process of tissue repair of second-degree burns, but the intervention during proliferative phase is crucial in the final outcome of the repair process.


Assuntos
Queimaduras/radioterapia , Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade , Animais , Queimaduras/patologia , Proliferação de Células , Colágeno Tipo I/metabolismo , Colágeno Tipo III/metabolismo , Tecido de Granulação/metabolismo , Tecido de Granulação/efeitos da radiação , Masculino , Ratos , Ratos Wistar , Reepitelização/efeitos da radiação , Fator de Crescimento Transformador beta/metabolismo , Resultado do Tratamento
8.
Dermatology ; 230(3): 276-81, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25720569

RESUMO

BACKGROUND: Large scalp defects devoid of periosteum following tumor excisions are a surgical challenge. In this case, drilling the outer table of the calvarium with a rose head burr is a standard method to induce granulation tissue. OBJECTIVES: We describe an alternative for trepanation or complete removal of the outer table of the calvarium. METHODS: We demonstrate the use of an erbium:yttrium-aluminum-garnet (erbium:YAG) laser for the induction of granulation tissue, compare this technique with the standard procedure and evaluate the benefits and limitations. RESULTS: The erbium:YAG laser is an excellent method for trepanation or complete removal of the outer table of the calvarium and induction of granulation tissue. Conclusion: The use of the laser for trepanation of the calvarium gives results comparable to those of the rose head burr for inducing granulation tissue but has its benefits. Therefore, this method should become a standard alternative to the known procedure.


Assuntos
Tecido de Granulação/efeitos da radiação , Crânio/cirurgia , Trepanação/instrumentação , Carcinoma de Células Escamosas/cirurgia , Tecido de Granulação/cirurgia , Humanos , Terapia a Laser , Lasers de Estado Sólido , Neoplasias Cutâneas/cirurgia , Neoplasias Cranianas/cirurgia , Tomografia Computadorizada por Raios X , Cicatrização/fisiologia , Cicatrização/efeitos da radiação
9.
Am J Vet Res ; 74(2): 324-32, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23363361

RESUMO

OBJECTIVE: To compare the effect of extracorporeal shock wave therapy (ESWT) on expression of fibroblast growth factor-7 (FGF-7), transforming growth factor-ß1 (TGF-ß1), insulin-like growth factor-1 (IGF-1), platelet-derived growth factor-A (PDGF), and vascular endothelial growth factor-A (VEGF) in skin with surgically created skin wounds and intact skin in horses. ANIMALS: 14 healthy horses. PROCEDURE: 8 horses were treated with ESWT at 6 locations along the neck at 36, 24, 12, 6, 2, or 1 hour prior to collection of full-thickness biopsy specimens from each location; a control specimen was collected from a sham-treated location. In 6 horses, 5 full-thickness wounds were created in each forelimb. Wounds in 1 forelimb/horse received ESWT immediately after creation and subsequently on days 7, 14, and 21; wounds in the contralateral forelimb remained untreated. Biopsy specimens were collected from 1 wound on each forelimb on days 7, 14, 21, 28, and 35. Expression levels of FGF-7, TGF-ß1, IGF-1, PDGF, and VEGF were assessed in tissue samples from the horses' necks and forelimbs. RESULTS: In surgically created wounds, ESWT treatment was associated with reduced TGF-ß1 expression, compared with expression in control wounds, during the entire study period. At 28 days following wound creation, IGF-1 expression was significantly increased for treated and untreated wounds, compared with findings on days 7, 14, 21, and 35. There was no significant effect of treatment on FGF-7, TGF-ß1, IGF-1, PDGF, or VEGF expression in intact skin. CONCLUSIONS AND CLINICAL RELEVANCE: Intervention with ESWT to suppress TGF-ß1 may decrease granulation tissue production, resulting in improved wound healing on the distal portion of horses' limbs.


Assuntos
Regulação da Expressão Gênica/efeitos da radiação , Ondas de Choque de Alta Energia/uso terapêutico , Cavalos/lesões , Peptídeos e Proteínas de Sinalização Intercelular/efeitos da radiação , Pele/efeitos da radiação , Cicatrização/efeitos da radiação , Animais , Feminino , Membro Anterior/lesões , Membro Anterior/metabolismo , Membro Anterior/patologia , Membro Anterior/efeitos da radiação , Tecido de Granulação/citologia , Tecido de Granulação/metabolismo , Tecido de Granulação/efeitos da radiação , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Masculino , Pescoço/patologia , Pescoço/efeitos da radiação , Lesões do Pescoço/metabolismo , Lesões do Pescoço/patologia , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Pele/lesões , Pele/metabolismo , Pele/patologia , Fatores de Tempo
10.
Photomed Laser Surg ; 29(9): 613-8, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21456943

RESUMO

OBJECTIVE: The aim of the present study was to evaluate whether LLLT at 830 nm is able to positively modulate trachea incisional wound healing in Sprague-Dawley rats. BACKGROUND DATA: Tracheotomy may be associated with numerous complications. Development of excess granulation tissue represents a late complication that may lead to airway occlusion. Low-level laser therapy (LLLT) has been shown to have stimulatory effects on wound healing of different tissues. Therefore, it may be suggested that LLLT could be able to positively modulate trachea wound healing as well. MATERIALS AND METHODS: Using general anesthesia, a median incision was performed from the second to the fifth tracheal cartilage ring in 24 rats. Animals were then randomly divided into sham-irradiated control and laser-treated groups. LLLT (power density: 450 mW/cm(2); total daily dose: 60 J/cm(2); irradiated area ∼1 cm(2)) treatment was performed daily during the first week after surgery. Samples for histological evaluation were removed 7 and 28 days after surgical procedure. Histological sections were stained with hematoxylin-eosin and van Gieson. RESULTS: Results from our investigation showed that LLLT was able to reduce granulation tissue formation and simultaneously increase new cartilage development at both evaluated time intervals. CONCLUSIONS: From this point of view, LLLT at 830 nm may be a valuable tool in trachea wound healing modulation. Nevertheless, further detailed research is needed to find optimal therapeutic parameters and to test these findings on other animal models.


Assuntos
Terapia com Luz de Baixa Intensidade , Traqueia/lesões , Traqueotomia , Cicatrização/efeitos da radiação , Ferimentos Penetrantes/radioterapia , Animais , Tecido de Granulação/patologia , Tecido de Granulação/efeitos da radiação , Masculino , Ratos , Ratos Sprague-Dawley , Traqueotomia/efeitos adversos , Ferimentos Penetrantes/etiologia , Ferimentos Penetrantes/patologia
11.
Photomed Laser Surg ; 29(9): 597-604, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21456947

RESUMO

BACKGROUND DATA: Low-level laser therapy (LLLT) has been reported to be capable of changing mast cell numbers and degranulation in experimental burns in rats. OBJECTIVE: We conducted a study of the influence of LLLT on mast cells in a rat model of third-degree burn. METHODS: In this study we divided 48 rats equally into two groups of 24 rats each. Third-degree burns were inflicted at three different locations on each rat in each group. The first burn site on rats in group I was treated with 890-nm pulsed laser, 75W peak, 80 Hz, 180 ns, average power 1mW, illuminated area 1 cm(2), 1 mW/cm(2), 856 sec, 0.924 J/cm(2). The second burn site on both groups of rats was treated with 0.2% nitrofurazone cream. Mast cell numbers and degranulation at each burn site on each group of rats were then assessed at 4, 8, 13, and 20 days after the infliction of burns. RESULTS: Analysis of variance on day 4 showed that the total numbers of mast cells were significantly lower at the laser-treated burn sites than at other burn sites on both groups of rats. On day 8 the total numbers of mast cells were again significantly lower at the laser-treated burn sites than at other burn sites, and on day 13, the numbers of both types 1 and 2 mast cells were significantly lower at the laser-treated burn sites than at other burn sites. CONCLUSIONS: We conclude that LLLT can significantly decrease total numbers of mast cells during the proliferation and remodeling phases of healing in a rat model of third-degree burn.


Assuntos
Queimaduras/radioterapia , Tecido de Granulação/efeitos da radiação , Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade , Mastócitos/efeitos da radiação , Animais , Queimaduras/patologia , Contagem de Células , Modelos Animais de Doenças , Masculino , Ratos , Ratos Wistar , Cicatrização/efeitos da radiação
12.
Lasers Surg Med ; 42(9): 656-64, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20976805

RESUMO

BACKGROUND AND OBJECTIVES: We have used a 660 nm, 80 mW laser diode in genetic diabetic mice to stimulate the healing of wounds covered with a Tegaderm HP dressing that causes a retardation of contraction (splinted wounds). The purpose of our study was to examine the effects of irradiating the wounds for different time intervals in order to determine a dose response relationship. MATERIALS AND METHODS: A circular excisional wound was made on the left flank of diabetic mice using a 5-mm skin punch, and covered with a Tegaderm HP dressing. Mice were allocated to four groups in which wounds were irradiated 660 nm, 80 mW for 0, 10, 20, or 40 seconds each day for 7 days. In total, 51 mice were used. Wounds were harvested on day 14 and the healing assessed from hematoxylin-eosin stained sections examined by light microscopy. RESULTS: The wounds were splinted in 40 of the mice, and splinting caused a retardation of healing. The findings for the four treatments showed that irradiation for 20 second/day for 7 days brought about the greatest extent of healing. The wounds healed mainly by re-epithelization and granulation tissue formation. This duration of irradiation represents an energy dose of 1.6 J per irradiation and, for an estimated area of irradiation of 32-43 mm², corresponds to an energy density of 3.7-5.0 J/cm². CONCLUSION: Irradiation with 660 nm, 80 mW at an energy density of 3.7-5.0 J/cm² each day for 7 days caused the maximal stimulation of healing in splinted wounds of diabetic mice.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Cicatrização/efeitos da radiação , Ferimentos Penetrantes/terapia , Animais , Bandagens , Modelos Animais de Doenças , Relação Dose-Resposta à Radiação , Feminino , Tecido de Granulação/patologia , Tecido de Granulação/efeitos da radiação , Masculino , Camundongos , Camundongos Endogâmicos NOD , Contenções , Ferimentos Penetrantes/etiologia , Ferimentos Penetrantes/patologia
13.
J Radiat Res ; 51(2): 181-6, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20057173

RESUMO

Irradiation before tooth extraction delays wound healing in the alveolar socket. This study examined the influences of local and whole body irradiation before tooth extraction on appearance of osteoblasts in the alveolar bone of rat maxillary first molars because bone formation is observed at the initial phase of wound healing. Several osteoblasts were generated 3 days after tooth extraction, and the number of cells increased day by day. Morphological studies showed there were little differences between local irradiation and non-irradiated controls. In contrast, the extraction wound in the whole body irradiation group showed delayed healing, and there was poor granulation tissue and very few osteoblasts at the bottom of the socket. An ultrastructural study showed that the osteoblasts in the extraction socket of whole body irradiation rats were smaller, and had poorly developed organelles. Injection of bone marrow cells to whole body-irradiated animals immediately after tooth extraction partially restored the number of osteoblasts. New periosteal bone formations outside of sockets showed little delay in the whole body irradiation group. These findings suggest that bone formation in the wound healing of extraction socket requires bone marrow cells from hematopoietic organs such as the bone marrow as well as local sources around the alveolar socket, during the initial phase of wound healing.


Assuntos
Osteoblastos/efeitos da radiação , Osteogênese/efeitos da radiação , Extração Dentária , Alvéolo Dental/efeitos da radiação , Irradiação Corporal Total , Cicatrização/efeitos da radiação , Animais , Movimento Celular , Fibroblastos/efeitos da radiação , Tecido de Granulação/efeitos da radiação , Células-Tronco Hematopoéticas/patologia , Masculino , Maxila/patologia , Maxila/efeitos da radiação , Dente Molar , Osteoblastos/ultraestrutura , Periósteo/efeitos da radiação , Periósteo/ultraestrutura , Ratos , Ratos Wistar , Alvéolo Dental/fisiopatologia
14.
Lasers Surg Med ; 41(6): 433-41, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19588536

RESUMO

OBJECTIVE: We tested the hypothesis that combined 660 and 890 nm LED phototherapy will promote healing of diabetic ulcers that failed to respond to other forms of treatment. RESEARCH DESIGN AND METHODS: A double-blind randomized placebo controlled design was used to study 23 diabetic leg ulcers in two groups of 14 patients. Group one ulcers were cleaned, dressed with 1% silver sulfadiazine cream and treated with "placebo" phototherapy (<1.0 J cm(-2)) twice per week, using a Dynatron Solaris 705(R) device. Group two ulcers were treated similarly but received 3 J cm(-2) dose. RESULTS: At each of 15, 30, 45, 60, 75, and 90 days of healing, mean ulcer granulation and healing rates were significantly higher for group two than the "placebo" group (P < 0.02). While "placebo" treated ulcers worsened during the initial 30 days, group two ulcers healed rapidly; achieving 56% more granulation and 79.2% faster healing by day 30, and maintaining similarly higher rates of granulation and healing over the "placebo" group all through. By day 90, 58.3% of group two ulcers had healed fully and 75% had achieved 90-100% healing. In contrast, only one "placebo" treated ulcer healed fully by day 90; no other ulcer attained > or =90% healing. CONCLUSION: Combined 660 and 890 nm light promotes rapid granulation and healing of diabetic ulcers that failed to respond to other forms of treatment.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Lasers Semicondutores/uso terapêutico , Úlcera da Perna/radioterapia , Terapia com Luz de Baixa Intensidade/instrumentação , Cicatrização/efeitos da radiação , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Diabetes Mellitus Tipo 2/patologia , Diabetes Mellitus Tipo 2/fisiopatologia , Método Duplo-Cego , Feminino , Tecido de Granulação/patologia , Tecido de Granulação/efeitos da radiação , Humanos , Úlcera da Perna/etiologia , Úlcera da Perna/patologia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
15.
J Am Vet Med Assoc ; 234(9): 1154-61, 2009 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-19405886

RESUMO

OBJECTIVE: To evaluate the effects of focused, extracorporeal shock wave therapy (ESWT) on the healing of wounds of the distal portion of the limbs in horses. DESIGN: Randomized controlled trial. ANIMALS: 6 healthy adult horses. PROCEDURES: In each horse, a 4-cm-diameter full-thickness wound that included underlying periosteum was created on the dorsomedial aspect of each metacarpus and two 3-cm-diameter full-thickness wounds that included underlying periosteum were created on the dorsomedial aspect of each metatarsus. One randomly selected metacarpal wound and a randomly selected pair of metatarsal wounds were treated once weekly with ESWT at an energy flux density of 0.11 mJ/mm(2). For metacarpal wounds, swab specimens were collected for bacterial culture on days 1, 2, and 3 and area of epithelialization and extent of wound contraction were measured at 3- to 4-day intervals. Metatarsal wounds were biopsied after 2 and 4 weeks, and immunohistochemical staining for vascular endothelial growth factor, transforming growth factor-beta1, and insulin-like growth factor-1 was performed. RESULTS: Results of bacterial culture, area of epithelialization, and percentage of wound contraction did not differ between treated and untreated wounds; however, healing time for treated wounds (mean, 76 days) was significantly shorter than healing time for untreated wounds (90 days). Staining intensity of growth factors did not differ significantly between treated and untreated wounds. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that ESWT may stimulate healing of wounds of the distal portion of the limbs in horses, although the mechanism by which healing was stimulated could not be identified.


Assuntos
Extremidades/lesões , Ondas de Choque de Alta Energia/uso terapêutico , Cavalos/lesões , Cicatrização/efeitos da radiação , Animais , Biópsia , Extremidades/patologia , Tecido de Granulação/patologia , Tecido de Granulação/efeitos da radiação , Processamento de Imagem Assistida por Computador , Imuno-Histoquímica/veterinária , Fator de Crescimento Insulin-Like I/análise , Fator de Crescimento Transformador beta/análise , Fator A de Crescimento do Endotélio Vascular/análise , Cicatrização/fisiologia , Ferimentos e Lesões/microbiologia , Ferimentos e Lesões/terapia , Ferimentos e Lesões/veterinária
16.
Int J Radiat Oncol Biol Phys ; 70(3): 701-6, 2008 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-17904764

RESUMO

PURPOSE: Benign endobronchial granulation tissue causes airway obstruction in up to 20% of patients after lung transplantation or stent placement. High-dose-rate endobronchial brachytherapy (HDR-EB) has been successful in some cases refractory to standard bronchoscopic interventions. METHODS AND MATERIALS: Between September 2004 and May 2005, 8 patients with refractory benign airway obstruction were treated with HDR-EB, using one to two fractions of Ir-192 prescribed to 7.1 Gy at a radius of 1 cm. Charts were retrospectively reviewed to evaluate subjective clinical response, forced expiratory volume in 1 second (FEV(1)), and frequency of therapeutic bronchoscopies over 6-month periods before and after HDR-EB. RESULTS: The median follow-up was 14.6 months, and median survival was 10.5 months. The mean number of bronchoscopic interventions improved from 3.1 procedures in the 6-month pretreatment period to 1.8 after HDR-EB. Mean FEV(1) improved from 36% predicted to 46% predicted. Six patients had a good-to-excellent subjective early response, but only one maintained this response beyond 6 months, and this was the only patient treated with HDR-EB within 24 h from the most recent bronchoscopic intervention. Five patients have expired from causes related to their chronic pulmonary disease, including one from hemoptysis resulting from a bronchoarterial fistula. CONCLUSION: High-dose-rate-EB may be an effective treatment for select patients with refractory hyperplastic granulation tissue causing recurrent airway stenosis. Performing HDR-EB within 24-48 h after excision of obstructive granulation tissue could further improve outcomes. Careful patient selection is important to maximize therapeutic benefit and minimize toxicity. The optimal patient population, dose, and timing of HDR-EB should be investigated prospectively.


Assuntos
Obstrução das Vias Respiratórias/radioterapia , Braquiterapia/métodos , Tecido de Granulação/efeitos da radiação , Adulto , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/mortalidade , Broncoscopia , Constrição Patológica/etiologia , Constrição Patológica/radioterapia , Feminino , Volume Expiratório Forçado , Tecido de Granulação/patologia , Humanos , Radioisótopos de Irídio/uso terapêutico , Transplante de Pulmão/efeitos adversos , Transplante de Pulmão/mortalidade , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos
17.
Vestn Khir Im I I Grek ; 166(5): 44-7, 2007.
Artigo em Russo | MEDLINE | ID: mdl-18154094

RESUMO

The article is devoted to using plasma flow for treatment of purulent wounds. The authors have shown an anti-inflammatory, antibacterial, stimulating effect of plasma radiation on the basis of clinical methods of control of the wound process in 143 patients (hypothermia, pain syndrome in rest, the presence of purulent discharge, edema, granulation tissue).


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Cicatrização/efeitos da radiação , Infecção dos Ferimentos/radioterapia , Seguimentos , Tecido de Granulação/efeitos da radiação , Humanos , Supuração , Resultado do Tratamento , Infecção dos Ferimentos/patologia
18.
Oral Health Prev Dent ; 5(1): 63-71, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17366763

RESUMO

PURPOSE: To present an animal model for mucositis induced by fluorouracil in rats, and test two therapeutic options, the GaAIAs laser and topical dexamethasone, analysing them with regard to the quality and quantity of tissue alterations and comparing them with the phases of mucositis. MATERIALS AND METHODS: Forty-five Wistar rats (250 g) were treated with fluorouracil (60 mg/kg) and, in order to mimic the clinical effect of chronic irritation, the palatal mucosa was irritated by superficial scratching with an 18-gauge needle. When all of the rats presented oral ulcers of mucositis, they were randomly allocated to one of three groups: group I was treated with laser (GaAIAs), group II was treated with topical dexamethasone, and group III was not treated. Excisional biopsies of the palatal mucosa were then performed, and the rats were killed. Tissue sections were stained with haematoxylin and eosin for morphological analyses, and with toluidine blue for mast-cell counts. RESULTS: Group I specimens showed higher prevalence of ulcers, bacterial biofilm, necrosis and vascularisation, while group II specimens showed higher prevalance of granulation tissue formation. There were no significant statistical differences in the numbers of mast cells and epithelial thickness between groups. CONCLUSION: For the present model of mucositis, rats with palatal mucositis treated with laser (GaAIAs) showed characteristics compatible with the ulcerative phase of oral mucositis, and rats treated with topical dexamethasone showed characteristics compatible with the healing phase of mucositis. Topical dexamethasone was more efficient in the treatment of rats' oral mucositis than the laser.


Assuntos
Anti-Inflamatórios/uso terapêutico , Antimetabólitos/efeitos adversos , Dexametasona/uso terapêutico , Fluoruracila/efeitos adversos , Glucocorticoides/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Estomatite/radioterapia , Alumínio , Animais , Arsenicais , Biofilmes/efeitos dos fármacos , Biofilmes/efeitos da radiação , Modelos Animais de Doenças , Gálio , Tecido de Granulação/efeitos dos fármacos , Tecido de Granulação/efeitos da radiação , Masculino , Mucosa Bucal/efeitos dos fármacos , Mucosa Bucal/patologia , Mucosa Bucal/efeitos da radiação , Necrose , Úlceras Orais/induzido quimicamente , Úlceras Orais/tratamento farmacológico , Úlceras Orais/radioterapia , Distribuição Aleatória , Ratos , Ratos Wistar , Estomatite/induzido quimicamente , Estomatite/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Cicatrização/efeitos da radiação
19.
Braz Dent J ; 18(3): 208-14, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18176711

RESUMO

The aim of this study was to assess the effect of low-dose electron irradiation on morphological features of the wound healing process in rat skin. Surgical wounds were inflicted with a 2.3 x 1.4 cm template on 84 male rats that were assigned to 4 groups: IG1, immediately irradiated; IG2, irradiated 3 days after inflicting the wound; CG1 and CG2, control groups. Rats in IG1 and IG2 groups had their wounds exposed to 1 Gy of 6 MeV electron beam radiation, immediately after surgery and on the third postoperative day, respectively. Qualitative and histophotometric evaluations of tissue repair structures were carried out. Data were analyzed by ANOVA and Tukey's test (alpha = 0.05) and regression analysis. The repair process was delayed since the first sacrifice time in both irradiated groups, but in IG1, wound healing was closer to that of CG1; whereas in IG2, the delay was more pronounced. Based on the histological findings, it is possible to conclude that a low-dose of electron radiation delayed tissue repair in rat skin. The delay was longer in the skin irradiated 3 days after the beginning of tissue repair. However, the low-energy electron irradiation did not prevent wound healing.


Assuntos
Partículas beta , Glicosaminoglicanos/efeitos da radiação , Tecido de Granulação/efeitos da radiação , Pele/efeitos da radiação , Cicatrização/efeitos da radiação , Animais , Procedimentos Cirúrgicos Dermatológicos , Relação Dose-Resposta à Radiação , Glicosaminoglicanos/metabolismo , Tecido de Granulação/metabolismo , Masculino , Doses de Radiação , Ratos , Ratos Wistar , Pele/metabolismo , Fatores de Tempo , Cicatrização/fisiologia
20.
Braz. dent. j ; 18(3): 208-214, 2007. ilus, tab
Artigo em Inglês | LILACS | ID: lil-471442

RESUMO

The aim of this study was to assess the effect of low-dose electron irradiation on morphological features of the wound healing process in rat skin. Surgical wounds were inflicted with a 2.3 x 1.4 cm template on 84 male rats that were assigned to 4 groups: IG1, immediately irradiated; IG2, irradiated 3 days after inflicting the wound; CG1 and CG2, control groups. Rats in IG1 and IG2 groups had their wounds exposed to 1 Gy of 6 MeV electron beam radiation, immediately after surgery and on the third postoperative day, respectively. Qualitative and histophotometric evaluations of tissue repair structures were carried out. Data were analyzed by ANOVA and Tukey's test (alpha = 0.05) and regression analysis. The repair process was delayed since the first sacrifice time in both irradiated groups, but in IG1, wound healing was closer to that of CG1; whereas in IG2, the delay was more pronounced. Based on the histological findings, it is possible to conclude that a low-dose of electron radiation delayed tissue repair in rat skin. The delay was longer in the skin irradiated 3 days after the beginning of tissue repair. However, the low-energy electron irradiation did not prevent wound healing.


O objetivo deste estudo foi avaliar o efeito da irradiação por baixa dose de elétrons sobre características morfológicas da reparação tecidual na pele de rato. Foram realizadas feridas cirúrgicas com um gabarito de 2,3 x 1,4 cm em 84 ratos machos, divididos em 4 grupos: IG1, irradiado imediatamente; IG2, irradiado 3 dias após a produção da ferida; CG1 e CG2, grupos controles. Os ratos dos grupos IG1 e IG2 tiveram suas feridas expostas a 1 Gy de radiação por elétrons com 6 MeV, imediatamente após a cirurgia e ao terceiro dia pós-operatório, respectivamente. Procedeu-se às avaliações qualitativas e histofotométrica das estruturas de reparação tecidual. Os dados foram submetidos a ANOVA e teste Tukey (a = 0,05) e análise de regressão. O processo de reparação apresentou-se atrasado desde o primeiro tempo de sacrifício em ambos os grupos irradiados, mas para IG1, a reparação tecidual foi similar a CG1. Por outro lado, para IG2, o retardo foi mais pronunciado. Com base nas avaliações histológicas, é possível concluir que uma baixa dose de radiação por elétrons retardou a reparação na pele de rato. O atraso foi maior na pele irradiada 3 dias após o início da reparação tecidual. No entanto, esta irradiação por elétrons de baixa energia não impediu a cicatrização.


Assuntos
Animais , Masculino , Ratos , Partículas beta , Glicosaminoglicanos/efeitos da radiação , Tecido de Granulação/efeitos da radiação , Pele/efeitos da radiação , Cicatrização/efeitos da radiação , Relação Dose-Resposta à Radiação , Glicosaminoglicanos/metabolismo , Tecido de Granulação/metabolismo , Doses de Radiação , Ratos Wistar , Pele/metabolismo , Pele/cirurgia , Fatores de Tempo , Cicatrização/fisiologia
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